Chapters authored
Sleep Physiology and Polysomnogram, Physiopathology and Symptomatology in Sleep Medicine By Murat Kayabekir
Over recent years, the importance of sleep physiology and pathology has been better understood in terms of correct diagnosis, treatment, prognosis and innovative research of diseases. Sleep disorders are often confused with clinical symptoms of adult and pediatric medical conditions. In medicine, electrophysiological signal recording methods are very important for establishing a correct diagnosis especially in neurological sciences. Polysomnography (PSG) is a golden standard diagnostic method that records electrophysiological signals used for sleep physiology and diseases. When the medical disciplines and diseases that make use of this diagnostic method are considered, its significance becomes clearer. For example, medical disciplines benefiting from PSG are as follows: “Clinical Physiology, Neurology, Ear Nose and Throat, Dentistry, Psychiatry, Pulmonology, Cardiology, Pediatric Neurology, Pediatric Cardiology, Internal Medicine, Neurosurgery, Endocrinology, etc.” The patient groups diagnosed with PSG are as follows: “Sleep Disordered Breathing (Central Sleep Apnea Syndrome, Obstructive Sleep Apnea Syndrome), Obesity, Morbid Obesity, REM Behavior Disorder, Restless Leg Syndrome, Rhythm Disorders, Epileptic Disorders, Insomnia, Insomnia and Headache, Hypersomnia, Narcolepsy, Secondary Hypertension, etc.” Interpretation and understanding electrophysiological signals correctly show us interactions of body systems with sleep physiology and integrated therapeutic approaches to sleep disorders. In conclusion; new approaches to sleep pathophysiology depend on a better understanding and further advancement of polysomnography.
Part of the book: Updates in Sleep Neurology and Obstructive Sleep Apnea
Diagnosis By Murat Kayabekir
Obstructive sleep apnea (OSA) is often confused with the clinical symptoms of other adult/pediatric medical conditions and neurological disorders. Since OSA affects all systems in the body, it is important to establish a correct diagnosis. The first step in the evaluation of a patient with a sleep disorder is to identify the primary symptom. A detailed history of the sleep and wakefulness cycles constitutes the second step. This is followed by the medical history of the patient; a list of previously used medications; family history; detailed information about school, work, family, and social life; and a physical exam of bodily systems. Relevant laboratory tests are performed for differential diagnosis. Polysomnography (PSG) is a golden standard diagnostic method that records electrophysiological signals used for sleep physiology and diseases. PSG is an indispensable method in the diagnosis of OSA.
Part of the book: Updates in Sleep Neurology and Obstructive Sleep Apnea
Neurophysiology of Basic Molecules Affecting Sleep and Wakefulness Mechanisms, Fundamentals of Sleep Pharmacology By Murat Kayabekir
As part of the biological rhythm, the human brain has a healthy functioning with the ability to differentiate between day and night hours in any given day (sleep rhythm, life rhythm). From the control of hormone levels to muscle tonus, from the regulation of respiratory rate to the content of our thoughts, sleep has an impact on all bodily and cognitive functions. It is not surprising to see such effects of sleep on the body as it leads to significant changes in the electrical activity of the brain in general. Electrical signal changes in the brain (sleep-wakefulness rhythm) are regulated by neurohormonal molecules and their receptors in the body. Neurotransmitters that control sleep and wakefulness can be listed as “Glutamate, Acetylcholine, Histamine, Norepinephrine and GABA”. Main hormones are: Melatonin, Corticotropin Releasing Hormone (CRH), cortisol, prolactin, Growth Hormone (GH), Insulin like Growth Factor (IGF-1, Somatomedin-C), Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH), progesterone, estrogen, testosterone, catecholamines, leptin and neuropeptide Y″. The effects of pharmacological agents on sleep and wakefulness cycles are materialized through the following molecules and their receptors: Hypnotics (GABA A agonists, benzodiazepines, gabapentin, tiagabine), sedative antidepressants (tricyclic antidepressants, trazadone, mitrazapine), antihistamines, medications used for the treatment of sleeplessness (melatonin and melatonin analogues), amphetamine (most commonly used stimulant), secretion of monoamines (dopamine), non-amphetamine stimulants used in the treatment of hypersomnia and narcolepsy (modafinil, bupropion, selegiline, caffeine) and other substances (alcohol, nicotine, anesthetics). To the extent we can conceptualize the physiological mechanisms of these basic molecules listed above and the regions they affect, we can appreciate the effects of these substances on sleep physiology and sleep disorders.
Part of the book: Sleep Medicine and the Evolution of Contemporary Sleep Pharmacotherapy
